▲ 6 r/vbac

How to deal with the dwindling hope of it happening.

I just need to feel my feelings you guys, sorry!

I had a normal first pregnancy, except for him scanning very large, so in the end we faced some pressure to induce. I also had a late repeat of a GD test that came back negative. My waters broke 40+4. He turned sunny side up during labor and then his head tilted forward, so he got stuck in a position where he was impossible to birth from, my OB said. We ended up with an unplanned c-section.

This time around, I have a very VBAC-friendly team. I think it's easier, because I'm in Europe. I just stated I wanted a VBAC and everyone was happy for me. My midwife basically called what happened during the first labor a "freak accident", meaning it rarely happens and is very unlikely to happen again. ANd then I got thrown a curveball, because this time I did test positive for GD. I also needed insulin, so my countries guidelines say that I have to be induced by 40+0.

I really don't want to be induced. Between the higher chances of induction leading to a CS, GD leading to CS and a previous CS I just don't like my chances. Also, cytotec hasn't been available in my country for months now (some error happened in the factory?) so I'm really only able to have the foley ballon. I have vaginismus, so I would really like to avoid the foley. (If the foley fails, they'll continue with off-label induction methods that are normally not recommened for a VBAC, but they are really not keen on it). I also wanted the epidural later this time around, because I couldn't move anymore once I got it the last time, even though it was supposed to be a "walking epidural". It made me feel really passive and out of control and I wanted to feel more in control during this labor. But with an induction, I don't think I'll be able to avoid it for very long. I don't have a high tolerance for pain.

But at first, I did like my chances. 40+0 isn't 37 weeks. I didn't go over my due date by a terrible long amount last time, so all I would need is for baby #2 to come a little earlier.

Well, tonight I'm 40+1. My midwife really fought for me and postponed my induction to 40+3. She's really pushed the limit for me!

But still, it means I have 36 hours left to go into labor naturally. Last time, I had lost my mucus plug by now. I could feel my body getting ready for labor. This time around, I've been having terrible BH for WEEKS now. But my midwife tried a membrane sweep at 39+5 and couldn't do it because my uterus was still so high. I don't feel like I'm gonna go into labor in the next 36 weeks. I know it can still happen.

But I'm loosing hope. And I know that an induction doesn't have to mean a failed VBAC. But ever since I couldn't birth my first son I feel like I have lost so much trust in my body to be able to birth vaginally. It feels like an obstacle I will not be able to overcome. And I know the best would be to go into all of this with an open mind, to be ready to accept a RCS if necessary. But I just find myself not able to do that. I'm just scared of another CS, I remember that terrible tugging from the first time, how I had to throw up the whole time, how it took my 5 days to be able to walk again. Simply, I have a really hard time being open minded and I feel like I'm loosing all hope that things can be redemptive this time around. Honestly, I'm so frustrated and angry with my baby, too and I feel terrible about that. But I really wanted him to come. I've been on edge for weeks now with the BH, always wondering if this could be the real deal, crying most nights because again another day has passed. I am so over all of this but I'm also so scared of getting induced and things going south again.

Thanks for attending my pity party, guys! Sorry, but my husband has been hearing this every night and I just needed an outlet.

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u/Tintenklex — 11 days ago
▲ 2 r/Mommit

Anyone else so surprised when your child’s language explosion suddenly started?

Im a FTM and I’m trying not to be obnoxious, so I am taking to the anonymity of the internet because I can’t really talk to my friends about without risking to look like an obnoxious mom, lol.

So I have a 2y1month old boy. He‘s always been early with word related stuff and slow with gross motor skills. we joke that he put all his skill points in language. I’ve got a phd in the humanities, so not a great surprise either.

So he’s been talking in 2-5 word sentences for about 6 months. started with the classic „Mama ball“ and moved on to a little more intricate stuff. (English isn’t our mother tongue, so can’t give great examples here.)

but recently he’s just had this explosion of language that kinda happened within 3 weeks?? he uses conjunctions like „and“. he uses articles correctly (German, so that means for most common words he uses the correct grammatical gender and article). he is using present Perfect and past Perfect to distinguisj between stuff happening in the past and stuff happening now.

just now he said to me „maybe I’ll go play in the sand, but first i eat my piece of cake.“

like thats…Future and present tense, it’s…just so coherent??? It’s driving my husband and myself crazy because we feel like weve gone from toddler speech to fully fledged language overnight. (he of course stI’ll also uses toddler language and learn new words and will be hard to understand with some sounds, it’s not like he’s a mini adult)

I suddenly feel like I’ve got a genius on hand, so I gotta ask the internet: is that just how it happens for everyone?? I knew about the word explosion, but do they just suddenly talk? How do you cope with that? It feels like we’ve moved on to a completely new phase. Please talk me down from my high horse before I start to brag about him to everyone who will listen, lol.

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u/Tintenklex — 3 months ago

If I have interrupted sleep when do you take your sugar?

I’ve reached the part of pregnancy where I lay awake between 5-6am, fall asleep again and then my toddler wakes me up between 7-7.30am.
my fasting sugars are too high so I’ve started on insulin, still searching for the right dosage. But I’ve wondered if I am awake so early but then fall asleep again, when should I take my readings? Is it artificially high at 7.00am? (I go to bed between 11pm-midnight, if that makes a difference).

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u/Tintenklex — 3 months ago

Is it worth the fight not to go on insulin?

As for many, my fasting numbers are the issue, as well as sometimes breakfast numbers. But I’ve learned not to look at a carb for breakfast and have a little bit of a bigger snack later in the morning m, when my morning insulin resistance is wearing off.

My fasting numbers are hovering around 95 for 2+ weeks. If I‘m religious about my evening walk and had some good sleep they are 91-95. If I mess up any of these things they creep up to 95-105. Baby’s measurements have normalized as has the amount of waters I have. My doctor says Im an edge case and it’s up to me if I want to go on night time insulin.

I’m week 30 and Im wondering how likely it is to keep this up till the end. If I were able to be diet controlled, it would give me more flexibility to avoid induction, which is good for me since I’m trying for a VBAC.
But right now I’m slightly pessimistic I’ll survive the weeks of rising insulin resistance if my sugars are so borderline even now. I’m wondering: is this worth the fight and stress? Is there a scientific benefit to staying off insulin as long as possible, even if it’s just another 2 or 5 weeks? Will this help with placental deterioration or give other benefits that make this whole thing more low risk? or would it just be better to lower my numbers more consistently through the help of insulin?

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u/Tintenklex — 3 months ago
▲ 20 r/vbac

Science-minded ppl: This expert on VBACs says risk of uterine rupture might be "as low as 0,1%", we simply don't know. What do you think?

So I listened to this german podcast https://www.youtube.com/watch?v=FLxLD4t1kY8 "die friedliche Geburt". The women doing the podcast is *the* person on hypnobirthing in Germany. She invited Dr. Wolf Lütje, retired OB-GYN, chief physician, with additional training in psychotherapy. According to himself he is still involved in re-writing most of the current guidelines around birth that are being put out (similar to ACOG in the US). He is president of the German Society of psychosomatic womens health and obstetrics. He is involved in re-writing the official guidelines on C-sections right now. He also does a bunch of other stuff, but I'm writing this to say he doesn't strike me as some random quack.

In the interview, he takes a very interesting position on the prevelance of uterine ruptures that I would love to share and discuss here. He's very pro-VBAC (he starts the podcast by telling a story of a successful VBA3C, that was also a twin-birth)

Basically, he thinks that there isn't a good distinction between uterine rupture and uterine dehiscence and that this leads to an overblown number of uterine rupture risk.

-He defines a rupture as a gap, where your waters can get into your abdominal cavity and worst case, part of the child can stick out as well. Interestingly, he says in this scenario, the most concerning part isn't some kind of bleeding, but placental abruption that will often go along with it, often leading to bleeding and danger to mother and child.

-He says in his clinical experience, he's seen about 2 cases of this in 60.000 births over 40 years of practice.

-How is this consistent with a min. 1% rupture risk (rising with risk factors?) that is often referred to in literature? He says it's because there is too little distinction between a rupture and a dehiscence. Often those will both be coded as the same thing in a c-section medical report, they will often be counted as the same thing in a study (personal observation: I stumbled on the same issue when I recently looked at a swedish cohort study that admitted to as much - very big, very recent study on VBACs in Sweden).

-A dehiscence he describes as the thinning of the scar: It'll grow apart, forming a window. When you perform a c-section, you can often see into the uterus as into a glass bowl. But they don't present the same danger and a dehiscence could have been present for a very long time already - they are sometimes discovered during other procedures as well. So there is no telling wether or not this would have developed into a rupture.

-Critically he said: What does a dehiscence often cause? Well because it's a scar and the contraction as muscular contractions, the scar tissue isn't able to help with that. This can lead to inconsistent or disturbed patterns of contraction. In practice, he'll often see that contractions are not strong enough in the pushing phase to get the child out. This causes stress to the baby, so in combination with the irregular contraction pattern will often lead to drop in heart rate, which will then lead to the decision to perform a c-section, during which the dehiscence will then be discovered. He isn't against performing a c-section in this case at all! On the contrary, he says that's a really important argument for having a birth being as "physiological" as possible, meaning without augmentation of labor by induction etc., because then it can more easily be assessed wether these symptoms occur and the birth will be possible. But he also stresses that this isn't the same as a rupture at all, doesn't present the same medical emergency to mother and baby and just isn't a good reason not to even attempt a TOLAC.

Two more points I found interesting:

  1. He said even after a dehiscence and a CBAC, the tissue gets sown together again and he can't see a reason why this should necessarily predict a re-occurence of a dehiscence, so not a reason not to have a TOLAC again.

  2. He pointed out that the risk of a rupture is the scar splitting and everything getting into the abdominal cave. But, he said, one thing that prevents that from happening is scar tissue. With more c-sections, you often have a higher build up of scar tissue. He thinks this might even be a factor that could lower the rupture risk of repeat c-section moms! But because a repeated pregnancy heigthens the risk for a uterine dehiscence (because the uterus has been "blown up" by the pregnancy repeatedly, leading to weakre tissue overall), which is then being reported as a uterine rupture, we see a statistical incline of rupture risks with repeated c-sections.

One point I found confusing:

-He pointed to a japanese study, where vbacs are very uncommon and which compared the risks between elective CBAC and VBACS. They reported on uterine ruptures even in the CBAC group, which he said shouldn't be a possible outcome since they never labored before. He took that as a sign that there wasn't enough distinction between rupture and dehiscence. But I haven't been able to find that study and I'm not sure what he's referring to.

In conclusion he says we simply have no idea what the real risk of uterine rupture is, as long as those two conditions are being mixed.

I'm curios what others think about this?

Personally, I'm inclined to believe parts of his arguments, as 1% always seemed very high to me as a statistically minded person. It sounds very little to a lay person, but 1 in 100 people suffering a terrible, life threatening medical event? That's actually a lot and I'm not seeing enough case reports on it. But I'll also say that he isn't presenting his own research, he is using his clinical experience and medical knowledge to argue why he doesn't find the current research convincing. As a researcher myself (though not from the medical field) this is something that will make me de-trust even the most eminent authority on a subject. Knowledge is often won by many people working together, piecing together information - not a single person having a stroke of genius. So I wouldn't take his guess of "0,1%" as anything but anecdotal.

But that's just my first thoughts on this. I really hope this can spark some discussion as I'm super curious what others think!! (If you disagree with him, please remember to not kill the messenger (me), but I'd love to hear your arguments and learn from them!)

u/Tintenklex — 3 months ago

Did controlling your GD help with babies size?

I've been diagnosed with GD at 27 weeks and I'm having horrible flashbacks to my first pregnancy (never diagnosed with GD) and feeling very stigmatized and shameful and sad.

My first pregnancy, baby was big - came out 4060g but average sized head and length. He was a chubby baby. We had so much trouble with that beforehand, lots of doctors advising for an elective c-section. In the end he came via secondary c-section after he got stuck in a position that's impossible to birth (sunny side up, chin forward). From what I was told this had likely nothing to do with his size. I was tested twice for GD, second time around week 32 because he was so big.

Now in my second with an official diagnosis. This time around at wk 20 baby was all normal and in the 50. percentile. But we had a scan at 24 weeks and he was again 95+ percentile in head, belly and weight, but short. So typical for macrosomia. Now I'm having that diagnosis and I'm reading these studies that show that an accelarated growth between wk 20-28 is often there with GD. That its more common with overweight and older moms (I'm 34 and have a BMI of 28)

And I just feel so terrible, that I might have caused this. I'm having these horrible, intrusive thoughts of wanting to starve both me and baby, so he can come out a normal weight. (I'm not doing this, it's just intrusive. Please don't shame me for it, it's shameful enough). It feels like by not controlling my weight enough before pregnancy, I'm now ruining it for my baby. But I'm really, really busy just surviving my life, doing my best in all these other areas. It feels overwhelming to also diet and control my weight, so that's who I became.

And now I'm wondering if there will be any hope of helping my baby not have macrosomia - and in turn having a greater chance of a VBAC, that I desperately wanted - by controlling my sugars? Or are things most likely too late and he'll just stay big till birth?

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u/Tintenklex — 3 months ago

Sollte ich als Schwangere die Sonderkulanz in Anspruch nehmen?

Hi,
ich frage mich gerade, wie ich die Sonderkulanz bezüglich Stornierungen fürs Wochenende einschätzen soll. Ich bin (ziemlich, d.h. im 3. Trimester) schwanger und plane einen Wochenendtrip von HH nach Süddeutschland (1x Umsteigen), den ich eigentlich richtig, richtig gerne antreten will. Vor Ort wird es auch nicht belastender als zuhause, also ist kein Sightseeing oder so geplant, nur gute Freunde treffen und gemeinsam im Dunkeln sitzen ;).

Jetzt frage ich mich, ob die Sonderkulanz mir irgendwas sagen soll:

Ist es wirklich nur Kulanz der Bahn, dass bei der Hitze manche Reisen (z.B. zum Sightseeing in einer süddeutschen Stadt) gerade richtiger Quatsch wären? Oder antizipiert die Bahn größere Probleme mit ihren Zügen bei der extremen Hitze?

Ich hab kein Problem mit den üblichen Verspätungen, aber bei dem Wetter würde ein Klimaanlagenausfall natürlich sofort einen Fahrtstopp bedeuten, und 3 Stunden in Bad Hintertupfingen auf den Anschlusszug bei 35° warten, wäre tatsächlich ziemlich krass für mich.

Und ich weiß: Ja, man weiß nie. Aber aus eurer Erfahrung, wieviel Störungsanfälliger ist denn der Bahnverkehr bei deutschen Höchsttemperaturen?

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u/Tintenklex — 4 months ago

Is there any likelyhood my toddler will pick up nursing again when I'll have my baby?

I have a 2y old and will be giving birth again in October. We weaned during pregnancy when things became painful and my milk started to dry up, which made our nights horrible because he kept trying to get more.

He's been night weaned (we initiated) and day weaned (he stopped nursing after getting sores from an infection, didn't want to nurse during and was fine to accept "milk empty" after the infection).

But he is still very fond of my boobies. For the first month or two since he's been weaned he would still "lick" (for lack of a better word, maybe "kiss"?) my nipple once or twice a day to check and then tell me that milk was empty. He's stopped doing it but he still very much likes to grab my breasts to self-soothe, both when he's a little worn out during the day and in the morning hours when his sleep will become more unrestful.

I'm theoretically open to tandem feeding, if my son wants it. But I'm just curious: Is there any chance he will actually go back to nursing once milk is in fact "not empty" anymore? Or will he not know how to nurse anymore/not really be interested in it? It'll be about a 5 month break, so I'm not sure if they just forget how it's done?

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u/Tintenklex — 4 months ago